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Abstract Pain is one of the most complex and unpleasant sensory and emotional human experiences. Pain relief continues to be a major medical challenge. Pain in trauma results from the chemical propagation of pain from injury, as well as the acute stress reaction from the traumatic event or injury that can create emotional distress that contributes to pain. Magnesium Sulphate as a medication is used to treat and prevent low blood magnesium, sedative and in seizures of women with eclampsia. It is also used in the treatment of Torsade’s de pointes, severe asthma exacerbations, constipation, and barium poisoning. Magnesium has an evolving role in pain management. Magnesium Sulphate (MgSO4), In terms of its anti-nociceptive role, magnesium blocks calcium influx, which inhibits central sensitization and decreases preexisting pain hypersensitivity. These properties have encouraged the research of magnesium as an adjuvant agent for intra- and post-operative analgesia. Moreover, the mentioned magnesium impacts are also detected in patients with neuropathic pain. Continuous use of opioid in ICU should be avoided as it has many complications. The most common side effects are sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. While delayed gastric emptying, hyperalgesia, immunologic and hormonal dysfunction, muscle rigidity, and myoclonus less common side effects. Intravenous magnesium Sulphate decreases opioid consumption and side effects related to opioid. Although magnesium is not a primary analgesic, it enhances the analgesic actions of more established analgesics as an adjuvant agent. The aim of this study was to decrease opioid use in trauma patients by using MgSO4 as an adjuvant agent for analgesia. This prospective randomized double blinded study was conducted on 50 trauma patients with musculoskeletal trauma. Patients were randomly divided into two equal groups. Group1: Experimental group (MgSO4): received a 30 mg/kg (maximum 4 g) dissolved in 100 ml normal saline using a labeled syringe and was given over 1 hour and repeated after 12 hours from admission. Group2: Control group (placebo): received 100 ml of normal saline was infused over 1 hour using a labeled syringe pump as a placebo drug and repeated after 12 hours. |